Doctors say they deserve preferential treatment on flights in case they are called upon to assist in a mid-air medical emergency.

The issue of doctors' responsibilities on aeroplanes has been in the headlines following the cases of two doctors who charged for their services in dealing with air emergencies.

Dr John Stevens charged American Airlines £540 for helping a woman suffering from a life-threatening blood clot. The airline refused to pay and Dr Stevens lost his case in the small claims court.

More recently, Dr Jonathan Levy has billed British Airways £1,350 for four-and-a-half hours' work treating a man with a burst peptic ulcer. It is BA policy not to pay doctors for in-flight assistance but the airline has given Dr Levy £500 worth of travel vouchers.

Now a survey shows that doctors want some kind of recompense if asked to assist, although they would not necessarily charge cash for their services.

It found that a majority of doctors back the idea of automatic seat upgrades in return for making their services available during the flight.

One senior doctor said that at the moment some doctors were even travelling "icognito" to avoid being called upon.

Findings

The survey was conducted by Doctor and Hospital Doctor, weekly newspapers for the medical profession. It found that 67% of the doctors who replied had been called upon to offer medical assistance.

Of these, 58% received a token of appreciation from the airline and five per cent got something from the patient.

However, doctors are sometimes reluctant to come forward and perform so-called Good Samaritan acts because of fear of legal action or because they have been drinking on the flight.

Three per cent of the doctors surveyed said they had declined giving medical advice on a flight. Of these, 29% said it was because they had had too much alcohol and 14% said it was because they feared being sued.

The survey showed that 59% of doctors who replied were in favour of a scheme whereby doctors would make themselves known at check in and agree to provide assistance if necessary during the flight.

They would also abstain from alcohol during the journey. In return doctors would receive a free seat upgrade.

Of the 575 doctors who took part in the self-selecting survey, 58% said that cabin crews should be better trained to provide medical assistance, and 31% said there should be a paramedic on every flight.

Aeroplanes' crews should include a doctor, 12% said, while eight per cent called for the inclusion of a nurse on every flight.

Alcohol fears

Dr Youssef Girgis is a specialist registrar in anaesthesia at Northampton General Hospital.

Doctors can expect to be disturbed in the event of a medical emergency

He once helped out on a flight to Cairo and in return had his excess baggage charges waived on the return trip.

He said the issue needed to be clarified so doctors knew exactly what they are dutybound to do on a flight, but that it was a complex area.

"If you get on board and take a couple of drinks, and then you're asked to provide medical assistance, it's a legal situation.

"A doctor working in a hospital is not to allowed to drink is not allowed to drink any alcohol, but if you're going on a holiday you start in a merry way.

"But if you're asked (to help) how do you react? Do you say 'I'm sorry, I'm the only doctor on board but I can't offer any assistance'?

"The matter must be regularised between flight companies."

At the moment British Airways offers automatic indemnity to all doctors on all its flights, but other airlines do not have a comprehensive policy on the issue.

Litigation

Dr Alan Green is a retired surgeon who has helped out on flights on two occasions.

He said it was disappointing that the practice of suing doctors was becoming more widespread, but that it should not stop doctors offering their help when requested.

He said he could not understand people who were medically qualified and who felt competent refusing assistance.

"One has to take a few risks in life and one does," he said.

The Medical Defence Union advises its members to offer assistance when they are asked, but only if they feel capable of dealing with the task.

Dr Peter Schütte, deputy head of advisory services, said: "The General Medical Council says quite clearly 'In an emergency, you must offer anyone at risk the treatment you could reasonably be expected to provide'."